Wirth R, Becker C, Djukic M, Drebenstedt C, Heppner H J, Jacobs A H, Meisel M, Michels G, Nau R, Pantel J, Bauer J M
Deutsche Gesellschaft für Geriatrie (DGG), Berlin, Deutschland.
Klinik für Altersmedizin und Frührehabilitation, Marien Hospital Herne - Universitätsklinikum der Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
Z Gerontol Geriatr. 2021 Mar;54(2):152-160. doi: 10.1007/s00391-021-01864-0. Epub 2021 Feb 17.
Predominantly the older population is affected by a severe course of COVID-19. The mortality of hospitalized patients with COVID-19 above the age of 80 years is up to 54% in international studies. These observations indicate the necessity to highlight the geriatric perspective on this disease. The diagnostics and treatment of COVID-19 do not differ between younger and older patients but atypical symptoms should be expected more frequently in old age. Older subjects show an increased need for rehabilitation after COVID-19. Paradoxically, increasing rehabilitation demands go along with a reduced availability of geriatric rehabilitation options, the latter being a consequence of closure or downsizing of rehabilitation departments during the pandemic. In general, measures of isolation and quarantine should be diligently balanced as the health and emotional consequences of such measures may be severe in older persons. In light of the poor prognosis of older COVID-19 patients, advanced care planning becomes even more relevant. Caregivers and physicians should be encouraged to compose advanced care directives that also reflect the specific circumstances of COVID-19. Fortunately, current data suggest that the effectiveness of the vaccination with the mRNA-vaccines approved in Germany may be equally high in older compared to younger persons.
主要是老年人群体受到新冠病毒疾病严重病程的影响。国际研究表明,80岁以上新冠病毒疾病住院患者的死亡率高达54%。这些观察结果表明有必要突出从老年医学角度看待这种疾病。新冠病毒疾病的诊断和治疗在年轻患者和老年患者之间并无差异,但老年患者更常出现非典型症状。老年患者在感染新冠病毒疾病后对康复的需求增加。矛盾的是,康复需求的增加伴随着老年康复选择的减少,后者是疫情期间康复科室关闭或规模缩减的结果。总体而言,隔离和检疫措施应谨慎权衡,因为此类措施对老年人的健康和情绪影响可能很严重。鉴于老年新冠病毒疾病患者预后不佳,预先护理计划变得更加重要。应鼓励护理人员和医生制定能反映新冠病毒疾病具体情况的预先护理指示。幸运的是,目前的数据表明,在德国获批的mRNA疫苗在老年人中的接种效果可能与年轻人一样高。